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For people diagnosed with dry age-related macular degeneration (dry AMD), the idea of losing sight can be scary. “I’ll do whatever it takes not to go blind,” wrote one member of myAMDteam.
AMD usually develops in stages — and, fortunately, most people don’t go completely blind from AMD. However, your vision may get worse as time goes on.
Read more to learn how long it may take to experience vision loss from dry AMD and what you can do to slow the condition’s progression.
The retina is a layer of tissue at the back of the eye that contains photoreceptor cells, which process light. AMD affects a part of the retina called the macula. The macula is responsible for producing central vision, which provides fine details in the center of your field of view. For example, the macula helps you read words on a page or screen or tell faces apart. If the macula is damaged, these details may become blurry, and blind spots may develop in your central vision.
— A myAMDteam member
There are two types of AMD: wet and dry. Wet AMD occurs when abnormal blood vessels form under the macula. These blood vessels leak fluid and can bleed beneath the macula.
Dry AMD is the more common form, affecting between 80 percent and 85 percent of people who have AMD. With dry AMD, small amounts of protein build up in the macula. These deposits are called drusen. As drusen accumulate, they damage photoreceptor cells and cause vision problems.
Some cases of dry AMD progress into wet AMD, but this is uncommon.
Dry AMD has three stages: early, intermediate, and late. Late-stage dry AMD is also called geographic atrophy.
In the earliest stage, your eye doctor may see drusen in your macula during an eye exam, but you probably won’t have any symptoms. You may find that your night vision is getting worse.
At the intermediate stage, larger drusen are found in the macula. Some people still don’t have symptoms at this point, but others experience blurriness, distortions, difficulty seeing in low light, or problems distinguishing contrast.
Geographic atrophy is the advanced stage of dry AMD. It happens when enough cells in the macula die to cause permanent blind spots called scotomas. These blind spots affect central vision to the point that it’s difficult to perform daily tasks like driving, cooking, and reading. However, peripheral vision remains unaffected.
Unlike wet AMD, which can progress very quickly, dry AMD usually progresses through its stages over the course of years. Up to 19 percent of people diagnosed with early- or intermediate-stage dry AMD progress to geographic atrophy within two years of diagnosis.
Being diagnosed with early- or intermediate-stage dry AMD doesn’t necessarily mean that the disease will progress. About 30 percent of people with dry AMD develop geographic atrophy.
If you’ve been diagnosed with dry AMD, your optometrist or ophthalmologist will give you an Amsler grid. This tool is a simple grid with a dot placed in the middle. If you see blurry, dark, or blank areas on the grid, your dry AMD may be progressing, and it’s time to speak with your eye doctor.
Doing the Amsler grid test every day will help you catch any changes in vision as soon as possible so you can seek treatment promptly.
Changing your diet can help improve your eye health and prevent dry AMD from progressing. Eating healthy fats and whole foods instead of sugars and processed ingredients is good for you in general, but it can be especially helpful for your eyes. The Mediterranean diet — an eating style that emphasizes fish, olive oil, fresh fruit and vegetables, nuts, and whole grains — may be especially helpful in preventing dry AMD progression. This diet is full of eye-healthy omega-3 fatty acids, which you can also obtain in algal oil.
Wearing sunglasses can prevent eye damage. Smoking is also a risk factor for retinal damage. Quitting smoking and staying away from secondhand smoke may help slow or limit damage from dry AMD.
Treatments for dry AMD and geographic atrophy include both a nutritional approach and two medications approved by the U.S. Food and Drug Administration (FDA).
A specific regimen of supplements called AREDS2 is also useful against dry AMD. This combination of nutrients contains vitamin C, vitamin E, copper, zinc, lutein, and zeaxanthin at precise dosages. Clinical trials have shown that this formula can slow the progression of dry AMD. However, AREDS2 supplements are recommended only for people who already have dry AMD and not as a preventive measure.
Pegcetacoplan (Syfovre) controls inflammation associated with geographic atrophy, slowing its progression. This FDA-approved medication is given by injection every 25 to 60 days.
Like Syfovre, avacincaptad pegol (Izervay) is an injection that slows the progress of geographic atrophy by controlling inflammation. The FDA has approved this drug to treat advanced and severe geographic atrophy.
Read more about treatment options for dry AMD.
On myAMDteam, the social network for people with age-related macular degeneration and their loved ones, members who understand life with AMD come together to offer support, share advice, and post their stories.
Have you noticed progression in your vision loss from dry AMD? What lifestyle changes or treatments have you tried to help slow AMD progression? Share your experience in the comments below, or post a comment on your Activities page.
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Christopher L. Haupert, M.D.
has 24 years of experience as a vitreoretinal surgeon with Iowa Retina Consultants.
Learn more about him here.
Jessica Wolpert
earned a B.A. in English from the University of Virginia and an MA in Literature and Medicine from King's College.
Learn more about her here.
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